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Early Senate measures to amend Obamacare fail, along with Rob Portman's amendment

Updated on July 25, 2017 at 11:13 PMPosted on July 25, 2017 at 10:20 PM

Ohio Sen. Rob Portman, shown here introducing Vice President Mike Pence at the Ohio Republican Party State Dinner on Saturday, tried to get an amendment passed Tuesday night as part of a broader Obamacare repeal-and-replace measure. The measure failed.

Ohio Sen. Rob Portman, shown here introducing Vice President Mike Pence at the Ohio Republican Party State Dinner on Saturday, tried to get an amendment passed Tuesday night as part of a broader Obamacare repeal-and-replace measure. The measure failed.(Jay LaPrete, Associated Press)

WASHINGTON -- An early Republican attempt to repeal and replace Obamacare failed Tuesday night, and with it, Sen. Rob Portman's proposal to help move people from Medicaid to private insurance went down.

It was unclear whether Portman will get another chance to offer his amendment, which would have added $100 billion to a stability fund that states could use to help Medicaid recipients get private insurance and pay deductibles and co-payments.

Portman also sought a related provision that would have allowed states to tap certain Medicaid dollars to also help pay for insurance costs when transitioning from Medicaid.

"This is a common-sense approach to help ensure that these low-income Americans have access to affordable care," Portman said on the Senate floor. "And I urge my colleagues to support it."

But as the proposal was brought up as part of a broader package, Portman's colleagues defeated it.

This was an early effort following the Senate's afternoon vote to proceed with a variety of proposals, all aimed at either ending or changing the Affordable Care Act. While the afternoon measure to proceed passed along partisan lines, the later proposals included a variety of features that required a higher threshold for voting.

The health care repeal and reform legislation is being considered under rules pertaining to budgeting, which require only a simple majority in the 100-member Senate. Republicans were able to meet that threshold, though just barely, early in the day.

But the provisions sought at night included some, including Portman's, that have not been analyzed for their effect on budgets, spending or deficits. That meant they could not be considered under budget rules and therefore needed 60 votes to pass. When Republicans tried to bring them up anyway, Democrats raised a procedural point of order, and to get past that, Republicans would have needed the 60 votes.

They got only 43, showing that even some Republicans didn't want parts of the package.

The bulk of the nighttime package was in the form of an amended bill, the Better Care Reconciliation Act, that Senate Republicans had in their sights already -- a bill to repeal the ACA and replace it with far less restrictive rules covering private insurance. It would have let insurance companies charge older customers more and younger ones less than under the ACA. It would have made it harder for some people to qualify for tax subsidies with which to buy insurance.

It also would have rolled back and eventually eliminated the Medicaid expansion that allowed 700,000 more Ohioans to enroll in the joint federal-state program for low-income Americans. And it would have cut future Medicaid spending for other enrollees as well, giving states more authority over how to spend their allotments.

Portman said earlier Tuesday that one reason he voted to proceed with the overall debate was an assurance that his amendment for the $100 million fund would get a vote. That has happened now, although it was part of the bigger package.

Also included in that package was an amendment from Sen. Ted Cruz, a Texas Republican who wanted to let health insurers offer policies with fewer benefits -- but lower costs -- in tandem with the policies they sell on the ACA market.

An analysis by Avalere, a health consulting firm, found these policies would be 77 percent less expensive. But because they would be attractive to healthier buyers, the consumer pool for remaining buyers would not be as varied and robust, forcing those premiums to rise by 39 percent. With the rise in premiums for those people and other factors, health insurance enrollment would fall by 4.1 percent under the Cruz proposal, Avalere said.

This was separate from a Congressional Budget Office analysis that considered many of the replace-and-repeal features being voted on Tuesday night. They would have reduced coverage for Americans by 22 million, the CBO said.

The Senate will continue with more votes Wednesday, including an attempt to repeal Obamacare without any replacement. It, too, is likely to fail.